Abstract
Objective: To evaluate the impact of smokeless tobacco (ST) on the inflammatory biomarkers Interleukin-1? (IL-1?) and Alpha-2-glycoprotein-1(AZGP1) in saliva and serum of ST consumers and non-ST consumers.Methods: This cross-sectional analytical study recruited a total of 124 individuals (62 ST consumers and 62 controls) aged 18-65 years who were recruited at Isra University Hospital, Hyderabad, Pakistan. Clinical assessments included the pain visual analog scale (VAS), swelling (buccal vestibule), and limitation in mouth opening, Decayed-Missing-Filled Teeth (DMFT) index, tooth mobility, and staining. Enzyme-linked immunosorbent assay (ELISA) was used to analyze the serum and saliva biomarkers. Independent t-tests, chi-square tests, and Pearson correlation coefficients were used to perform statistical analysis.Results: ST consumers exhibited markedly higher inflammatory markers. The IL-1? in saliva increased by 2.35-fold (42.8 ± 18.3 vs 18.2 ± 9.4 pg/mL, mean difference 24.6, 95% CI 19.8-29.4, p<0.001) and serum IL-1? by 2.81-fold (8.7 ± 4.2 vs 3.1 ± 1.8 pg/mL, mean difference 5.6, 95% CI 4.4-6.8, p<0.001). The level of AZGP1 in the saliva was higher (156.4 ± 52.7 vs 98.3 ± 31.2 ng/mL,mean difference 58.1, 95% CI 43.1-73.1, p<0.001), whereas serum AZGP1 was lower (24.6 ± 8.9 vs32.8 ± 7.1 ng/mL, mean difference -8.2, 95% CI -11.1 to -5.3, p<0.001). Strong dose-response relationships were determined between the duration/frequency of ST and the intensity of biomarkers (r=0.47-0.71, 95% CI ranging approximately 0.03-0.82 across individual correlations, p<0.001). Clinically, ST consumers had pain scores approximately four times higher and DMFT indices twice thoseof controls.Conclusion: ST consumption is significantly associated with elevated salivary and serum inflammatory biomarkers, which correlate with clinical deterioration.